Other Project Information Project Summary/Abstract Wayne State University (WSU) was one of the seven academic centers that established the NICHD Neonatal Research Network (NRN) in 1986 and has re-competed successfully during each 5-year cycle. Seetha Shankaran, M.D. is the only Principal Investigator (PI) to lead an NRN site since 1985 to the present. The long term objective of the WSU site of the NICHD NRN is to improve the health of the fetus and the neonate and to decrease neonatal morbidity and mortality. WSU site investigators will continue to examine gaps in knowledge in neonatal care. To address these areas requiring investigation, the WSU team will work with the NICHD NRN investigators to carry out the following objectives: to conduct randomized controlled trials of unproven therapies or promising therapies, to conduct observational studies evaluating infants at highest risk while examining their outcomes and to disseminate the results of NRN studies to the scientific and lay community. Currently the WSU site principal investigator (PI) is the NRN PI of a trial evaluating whether longer or deeper cooling will decrease death and disability following neonatal hypoxic-ischemic encephalopathy compared to standard of care cooling for 72 hours to a depth of 33.5C. This is a randomized controlled factorial-design trial that will complete th 18-22 month follow-up of the enrolled subjects within the next 6 months. The WSU PI will be involved in reviewing study data, assisting in statistical analysis and reporting of results at the next annual meeting of the Pediatric Academic Societies along with submission of the manuscript to the Journal of American Medical association. The trial results may demonstrate which cooling regimen will reduce the rate of disabilities in early childhood. The WSU PI is also the NRN PI of another randomized controlled trial of weaning moderate preterm neonates at a higher vs. lower weight from the incubator to the crib. The WSU team will be involved with study data analysis and reporting of results, similar to study mentioned above. This incubator-weaning study may have economic benefits if moderate preterm infants can be weaned at lower weights and thus have a shorter length of hospital stay. A third study led by the Alternate-PI at the WSU site is designed to examine the cardiac effects of hydrocortisone therapy and is enrolling subjects from the ongoing RCT of hydrocortisone to prevent bronchopulmonary dysplasia and increase survival without morbidity. This study involves close collaboration with a pediatric cardiologist at WSU who serves as the central reader of all echocardiograms and knowledge gained may help develop approaches to reduce cardiac dysfunction among these infants. Thus the WSU site is well suited to achieving the stated goals.